NPIMap

Organization Active NPI

Pediatric Cardiology Center of Oregon PC

Doing business as Childrens Cardiac Center of Oregon

  • Pediatric Cardiology Physician
  • Portland, OR
National Provider Identifier
1144287541
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
PEDIATRIC CARDIOLOGY CENTER OF OREGON PC
Doing business as
Childrens Cardiac Center of Oregon
Practice address
300 N Graham St
Suite 250
Portland, OR 97227-1683
Phone
(503) 280-3418
Fax
(503) 284-7885
NPI assigned
Apr 28, 2006
Last updated
Jul 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amanda L. Lamb
Title
Business Administrator
Phone
(503) 280-3418

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X NU Primary

Addresses

Primary practice location

300 N Graham St
Suite 250
Portland, OR 97227-1683

Mailing address

PO Box 821350
Vancouver, WA 98682-0030
Phone (503) 280-3418

Other identifiers 2

IdentifierTypeStateIssuer
057775000OtherORBLUE CROSS
0000WFBXLOtherORMEDICARE ID

Other names 1

  • Childrens Cardiac Center of Oregon Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040804000484 OR Part B Supplier - Clinic/Group Practice 7911978804 Receives reassigned benefits from 8 practitioners
Practice locations: Medford, OR; The Dalles, OR; Portland, OR; Grants Pass, OR; Bend, OR

National Provider Directory

National Provider Directory

Locations

1465 NE 7th St
Grants Pass, OR 97526
Phone (541) 471-0100

1465 NE 7th St
Ste B
Grants Pass, OR 97526
Phone (541) 471-0100

300 N Graham St
Ste 250
Portland, OR 97227
Phone (503) 208-3418

501 N Graham St
Ste 220
Portland, OR 97227
Phone (503) 413-4710

1935 E 19th St
Ste 110
The Dalles, OR 97058
Phone (541) 296-7280

700 NE 87th Ave
#110
Vancouver, WA 98664
Phone (503) 289-4353

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIEBDD

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1144287541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 821350",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986820030",
            "telephone_number": "503-280-3418",
            "fax_number": "503-284-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N GRAHAM ST",
            "address_2": "SUITE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271683",
            "telephone_number": "503-280-3418",
            "fax_number": "503-284-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARDIOLOGY CENTER OF OREGON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "LAMB",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "503-280-3418"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "057775000",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "0000WFBXL",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Childrens Cardiac Center of Oregon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Childrens Cardiac Center of Oregon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.